Health Equity blog

In response to refusal by certain Democratic-controlled states to provide information concerning potential food stamp fraud, the U.S. Department of Agriculture (USDA) is threatening to withhold their Supplemental Nutrition Assistance Program (SNAP) benefits. In response, Democratic-led states have sued the Trump administration, which resulted in a federal judge issuing a preliminary injunction. However, in late November, the federal government sent a letter, stating that it was time for the states to comply, although the parties then agreed to a December 8 response date. Any disruption in SNAP benefits hits particularly hard on disadvantaged populations, including Native Tribal communities for which more than 60% rely upon SNAP to meet their basic food needs. Such communities already faced food instability when SNAP benefits were denied during the federal government shutdown earlier this year.

For women who test negative for the hepatitis B virus, the Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) now recommends individualized vaccine decision-making by parents, along with the advice of their health care providers, including for the routinely administered birth dose after the group voted to change its previous recommendation. Formal advice includes parents evaluating the vaccine’s risks/benefits and consulting with their health care provider to decide if their child should begin the hepatitis B vaccine series. ACIP’s recommendation was adopted by the CDC on December 16, becoming part of the CDC’s child immunization schedule. This represents a large shift in the previous recommendation has come with broad criticism from the health care community, including from the American Academy of Pediatrics and an AMA trustee. Several state and state health agencies, including the Michigan Department of Health and Human Services, and the West Coast Health Alliance, a public health consortium made up of California, Oregon, Washington, and Hawaii, have also issued statements opposing ACIP’s new recommendation.

On November 6, 2025, the Trump administration announced agreements with Eli Lilly and Co. and Novo Nordisk to reduce prices for certain medications used treat obesity, diabetes, and heart disease, including Ozempic and Wegovy, among others. Under these agreements, monthly costs for these drugs will decrease through a new federal purchasing platform, TrumpRx, with further reductions planned for Medicare and Medicaid programs. The agreements also require Eli Lilly and Novo Nordisk to honor most favored nation (MFN) pricing on all new medications that they bring to market and provide every Medicaid program in the country access to MFN drug pricing on their products. The Trump administration’s actions come on the heels of last month’s announcement by California’s Governor Newsom that it reached an agreement with Civica Rx and Biocon Biologics to make CalRx® Insulin Glargine (a medication essential to managing diabetes) available to consumers at an average cost of $11 per pen beginning Jan. 1, 2026. Insulin affordability has been a persistent health care challenge in the U.S.

A Health Policy Brief published by Health Affairs earlier this month provides an evidence review that examines how expanding exclusionary immigration policies, including recent federal actions to broaden deportation efforts and limit previous immigration protections, are harmful to community health. The review found that increased deportations and other immigration enforcement adversely impact mental health and birth outcomes, diminish health care use, and erode trust in governmental health information sources, which affect not only undocumented immigrants and their families, but minority racial and ethnic groups as well. The review also suggests potential policy actions to limit state and local law enforcement’s collaboration with federal immigration authorities and make driver’s licenses more widely available for undocumented immigrants.

A study of first-year medical residents published online earlier this month in JAMA Network Open found that more than 70% have at least some level of bilingual language proficiency. While such a statistic appears promising, many residency programs nonetheless fail to match physician language skills with the needs of patients possessing limited English proficiency. Moreover, the study determined that fewer than 200 first-year residents with advanced or native language skills are available per 100,000 limited English proficiency patients and, somewhat surprisingly, a particularly low ratio for such commonly spoken languages as Spanish. The study highlights the need for medical education and training to more appropriately align multilingual candidates with programs serving patients who can benefit from them.

A recent article published by Kaiser Family Foundation (KFF), reports that CMS has ordered states to investigate whether their Medicaid programs are providing benefits to individuals whose immigration status renders them legally ineligible. Medicaid is only available to U.S. citizens and some lawfully present immigrants. In August, CMS began sending state Medicaid agencies the names of enrollees who it suspected may be ineligible, requesting verification of such individuals’ immigration status. Some states have objected to CMS’s demands, claiming that the federal government’s projected figures of ineligible recipients are overstated for several reasons, including misidentification, and that these latest efforts are duplicative of eligibility verification processes already in place, not to mention inadvertently excluding eligible individuals due to such administrative challenges as missing paperwork.

KFF recently reported that U.S. Department of Health and Human Services’ Office of Population Affairs (OPA) has largely ceased operations following federal layoffs. OPA administers the Title X family planning program, which provides contraception, pregnancy testing, and other primary and preventive care to almost 3 million low-income or uninsured patients annually. These developments, combined with recent Medicaid reductions, the potential lapse of Affordable Care Act (ACA) premium subsidies, and funding cuts across the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) programs, have raised concerns about the long-term stability of the reproductive health safety net.

On Nov. 10, the Food and Drug Administration (FDA) announced plans to revise labeling for hormone replacement therapy (HRT) products used to treat menopause. The agency will remove boxed warning references to cardiovascular disease, breast cancer, and probable dementia, citing updated evidence that these risks were overstated in earlier studies. However, the FDA is leaving in place the boxed warning for endometrial cancer for systemic estrogen-alone products. According to the FDA, these changes are intended to reflect current science and support informed decision-making for women considering HRT.

September 4, the U.S. District Court for the Northern District of Georgia issued a preliminary injunction that partially blocks enforcement of a state law that went into effect in May 2025. This law was intended to prohibit “controversial procedures,” including surgical, hormone or cosmetic procedures to treat gender dysphoria, being performed on inmates. The preliminary injunction pertains to the provision of hormone therapy, and orders the continued provision of hormone therapy and evaluations for hormone therapy. In issuing the preliminary injunction, the court concluded that the state law likely violates the prisoners’ Eighth Amendment right against cruel and unusual punishment.

A recent study published by The Commonwealth Fund found that work mandates for Medicaid beneficiaries in states that expanded Medicaid eligibility under the Affordable Care Act (ACA) will have significant adverse financial impacts on hospitals, particularly safety net institutions. Specifically, individuals who fail to comply with work obligations risk losing Medicaid coverage, which could drastically increase the percentage of patients who are uninsured and erode already thin hospital operating margins.